ATLS; Comprehensive Trauma
Management and Emergency
Procedures Questions and Answers
Immediate action for ventilated patient with SpOI drop - Answer-Needle decompress left
chest
Best immediate therapy for carbon monoxide poisoning - Answer-High-flow 100%
oxygen via nonrebreather
Best first step to control hemorrhage in open tibia fracture - Answer-Direct pressure,
then tourniquet if needed
Next best step for chest pain after rapid deceleration crash - Answer-CT angiography of
chest
Best next test for stable child with blunt abdominal trauma - Answer-CT abdomen/pelvis
with IV contrast
Next priority after applying pelvic binder in hypotensive patient - Answer-Massive
transfusion with balanced products
Finding contraindicating urethral catheter insertion after pelvic trauma - Answer-Perineal
hematoma and high-riding prostate
Initial management for head trauma patient on warfarin - Answer-Immediate head CT
and reversal of anticoagulation if indicated
Esophageal intubation - Answer-A potential cause of rising peak pressures and
subcutaneous emphysema in an intubated trauma patient.
Tension pneumothorax - Answer-Most likely cause of rising peak pressures and
subcutaneous emphysema in an intubated trauma patient.
Aspiration - Answer-A possible cause of complications in an intubated trauma patient.
Pulmonary edema - Answer-A potential cause of rising peak pressures in an intubated
trauma patient.
Basilar skull fracture - Answer-Condition suggested by raccoon eyes or Battle's sign,
indicating risk of CSF leak.
, CT abdomen/pelvis with IV contrast - Answer-Preferred diagnostic step for a stable
patient with penetrating abdominal trauma and localized tenderness.
Partial-thickness flame burns - Answer-Condition affecting both arms and anterior trunk,
with an approximate TBSA of 27%.
Parkland formula - Answer-Initial fluid calculation formula for burn patients: 4
mL/kg/%TBSA in first 24 hours.
Left lateral uterine displacement - Answer-Best immediate maneuver for a hypotensive
pregnant trauma patient when supine.
Compartment syndrome - Answer-Condition indicated by pain out of proportion with
passive stretch pain in a crush injury patient.
Inhalation injury - Answer-Condition in a child with facial burns and carbonaceous
sputum, requiring early airway planning.
Blunt cardiac injury - Answer-Condition that requires serial ECG/troponins and
monitoring in a patient with a sternal fracture.
Open-book pelvis - Answer-Condition in a hypotensive patient requiring hemorrhage
control options like angioembolization.
Hyperbaric oxygen therapy - Answer-Best specific therapy for a diver who develops
acute chest pain and neurologic deficits after rapid ascent.
Awake fiberoptic intubation - Answer-Immediate airway step for a patient with facial
fractures and declining mental status.
Hypothermic avalanche victim - Answer-Condition where the best resuscitation principle
is to continue rewarming and ALS until warm and dead.
Intracranial pressure (ICP) - Answer-Condition that is considered elevated at > 25 mm
Hg in a patient with severe head injury.
Mannitol - Answer-Next step for managing elevated ICP in a patient with severe head
injury.
Next diagnostic step for hypotensive 19-year-old with blunt abdominal trauma - Answer-
Pelvic x-ray
Parameter that best reflects tissue perfusion during resuscitation - Answer-Base deficit /
lactate trend
Management and Emergency
Procedures Questions and Answers
Immediate action for ventilated patient with SpOI drop - Answer-Needle decompress left
chest
Best immediate therapy for carbon monoxide poisoning - Answer-High-flow 100%
oxygen via nonrebreather
Best first step to control hemorrhage in open tibia fracture - Answer-Direct pressure,
then tourniquet if needed
Next best step for chest pain after rapid deceleration crash - Answer-CT angiography of
chest
Best next test for stable child with blunt abdominal trauma - Answer-CT abdomen/pelvis
with IV contrast
Next priority after applying pelvic binder in hypotensive patient - Answer-Massive
transfusion with balanced products
Finding contraindicating urethral catheter insertion after pelvic trauma - Answer-Perineal
hematoma and high-riding prostate
Initial management for head trauma patient on warfarin - Answer-Immediate head CT
and reversal of anticoagulation if indicated
Esophageal intubation - Answer-A potential cause of rising peak pressures and
subcutaneous emphysema in an intubated trauma patient.
Tension pneumothorax - Answer-Most likely cause of rising peak pressures and
subcutaneous emphysema in an intubated trauma patient.
Aspiration - Answer-A possible cause of complications in an intubated trauma patient.
Pulmonary edema - Answer-A potential cause of rising peak pressures in an intubated
trauma patient.
Basilar skull fracture - Answer-Condition suggested by raccoon eyes or Battle's sign,
indicating risk of CSF leak.
, CT abdomen/pelvis with IV contrast - Answer-Preferred diagnostic step for a stable
patient with penetrating abdominal trauma and localized tenderness.
Partial-thickness flame burns - Answer-Condition affecting both arms and anterior trunk,
with an approximate TBSA of 27%.
Parkland formula - Answer-Initial fluid calculation formula for burn patients: 4
mL/kg/%TBSA in first 24 hours.
Left lateral uterine displacement - Answer-Best immediate maneuver for a hypotensive
pregnant trauma patient when supine.
Compartment syndrome - Answer-Condition indicated by pain out of proportion with
passive stretch pain in a crush injury patient.
Inhalation injury - Answer-Condition in a child with facial burns and carbonaceous
sputum, requiring early airway planning.
Blunt cardiac injury - Answer-Condition that requires serial ECG/troponins and
monitoring in a patient with a sternal fracture.
Open-book pelvis - Answer-Condition in a hypotensive patient requiring hemorrhage
control options like angioembolization.
Hyperbaric oxygen therapy - Answer-Best specific therapy for a diver who develops
acute chest pain and neurologic deficits after rapid ascent.
Awake fiberoptic intubation - Answer-Immediate airway step for a patient with facial
fractures and declining mental status.
Hypothermic avalanche victim - Answer-Condition where the best resuscitation principle
is to continue rewarming and ALS until warm and dead.
Intracranial pressure (ICP) - Answer-Condition that is considered elevated at > 25 mm
Hg in a patient with severe head injury.
Mannitol - Answer-Next step for managing elevated ICP in a patient with severe head
injury.
Next diagnostic step for hypotensive 19-year-old with blunt abdominal trauma - Answer-
Pelvic x-ray
Parameter that best reflects tissue perfusion during resuscitation - Answer-Base deficit /
lactate trend
